ACLS Study Guide - Virb › Build your own...
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ACLS Study Guide Express Training Solutions | www.ExpressTraining.com | 888.815.0313 Pre-Course Self-Assessment The ACLS course now has a mandatory pre-course self-assessment with a passing score of at least 70%. Students may take the self-assessment as many times as needed. Please bring your assessment results with you to the ACLS class or email in advance to [email protected]. Instructions for accessing the self-assessment are included in your registration confirmation. Pre-Course Videos Follow the link in your registration email to access the pre-course self-assessment > enter access code ACLS15 & click submit > DO NOT click launch… scroll down to access the videos instead. ACLS Written Exam The ACLS Provider exam is 50 multiple-choice questions, with a required passing score is 84%. All AHA exams are now “open resource” which means student may use the ACLS manual, study guides, handouts and personal notes during the exam. Using the ACLS Provider Manual ahead of time with the online resources is very helpful. BLS Review Assessment Steps for BLS 1. Make sure scene is safe 2. Tap/shout to check for responsiveness 3. Call for help if patient is unresponsive 4. Check for pulse and breathing for at least 5 but no more than 10 seconds 5. If no pulse (or not sure if there is a pulse) begin CPR Compressions • At least 2 inches with a rate between 100 – 120/min • Allow for full recoil • Lower half of the breast bone • PEtCO2 (intubated) < 10 mmHg indicates poor compressions • Interruptions in compressions should be < 10 seconds • Switch compressors every 2 min. Breaths During CPR • Ratio of compressions to breaths 30:2 • Each breath given over 1 second • An effective breath will result in visible chest rise • CPR with ETT: 1 breath every 6 seconds with continuous compressions • Verify ETT placement in code: waveform capnography • Excessive ventilation = decreased cardiac output Rescue Breathing • For a patient who is not breathing or breathing effectively • Give 1 breath every 5-6 seconds • Each breath given over 1 second • An effective breath will result in visible rise/fall of the chest • Excessive ventilation decreases cardiac output • Difficulty positioning airway for patency, place NPA or OPA • OPA Placement = Measure from the corner of the mouth to the angle of the mandible ACS and Stroke ACS - STEMI • Assessment: Pale, cool, diaphoretic, chest pain, dyspnea, anxiety, hypotension, poor perfusion • Aspirin 160-325 mg • Time frame to start Coronary Reperfusion < 90min Stroke • Head CT within 25 min. (normal CT may rule out hemorrhagic) • To better facilitate care, notify receiving hospital in advance • Ischemic Stroke: start fibrinolytic therapy ASAP • Hemorrhagic Stroke: neuro consult RRT and MET (Rapid Response Team / Medical Emergency Team) • MET / RRT focuses on prevention of deuteriation to cardiac arrest • Improve patient care by identifying and treating early clinical deterioration
Transcript of ACLS Study Guide - Virb › Build your own...
ACLSStudyGuide
ExpressTrainingSolutions|www.ExpressTraining.com|888.815.0313
Pre-CourseSelf-AssessmentTheACLScoursenowhasamandatorypre-courseself-assessmentwithapassingscoreofatleast70%.Studentsmaytaketheself-assessmentasmanytimesasneeded.PleasebringyourassessmentresultswithyoutotheACLSclassoremailinadvancetoinfo@expresstraining.com.Instructionsforaccessingtheself-assessmentareincludedinyourregistrationconfirmation.
Pre-CourseVideosFollowthelinkinyourregistrationemailtoaccessthepre-courseself-assessment>enteraccesscodeACLS15&clicksubmit>DONOTclicklaunch…scrolldowntoaccessthevideosinstead.ACLSWrittenExamTheACLSProviderexamis50multiple-choicequestions,witharequiredpassingscoreis84%.AllAHAexamsarenow“openresource”whichmeansstudentmayusetheACLSmanual,studyguides,handoutsandpersonalnotesduringtheexam.UsingtheACLSProviderManualaheadoftimewiththeonlineresourcesisveryhelpful.BLSReview
AssessmentStepsforBLS1. Makesuresceneissafe2. Tap/shouttocheckforresponsiveness3. Callforhelpifpatientisunresponsive4. Checkforpulseandbreathingforatleast5butno
morethan10seconds5. Ifnopulse(ornotsureifthereisapulse)beginCPR
Compressions• Atleast2incheswitharatebetween100–120/min• Allowforfullrecoil• Lowerhalfofthebreastbone• PEtCO2(intubated)<10mmHgindicatespoorcompressions• Interruptionsincompressionsshouldbe<10seconds• Switchcompressorsevery2min.
BreathsDuringCPR• Ratioofcompressionstobreaths30:2• Eachbreathgivenover1second• Aneffectivebreathwillresultinvisiblechestrise• CPRwithETT:1breathevery6secondswith
continuouscompressions• VerifyETTplacementincode:waveformcapnography• Excessiveventilation=decreasedcardiacoutput
RescueBreathing• Forapatientwhoisnotbreathingorbreathingeffectively• Give1breathevery5-6seconds• Eachbreathgivenover1second• Aneffectivebreathwillresultinvisiblerise/fallofthechest• Excessiveventilationdecreasescardiacoutput• Difficultypositioningairwayforpatency,placeNPAorOPA• OPAPlacement=Measurefromthecornerofthemouthto
theangleofthemandibleACSandStroke
ACS-STEMI• Assessment:Pale,cool,diaphoretic,chestpain,
dyspnea,anxiety,hypotension,poorperfusion• Aspirin160-325mg• TimeframetostartCoronaryReperfusion<90min
Stroke• HeadCTwithin25min.(normalCTmayruleouthemorrhagic)• Tobetterfacilitatecare,notifyreceivinghospitalinadvance• IschemicStroke:startfibrinolytictherapyASAP• HemorrhagicStroke:neuroconsult
RRTandMET(RapidResponseTeam/MedicalEmergencyTeam)
• MET/RRTfocusesonpreventionofdeuteriationtocardiacarrest• Improvepatientcarebyidentifyingandtreatingearlyclinicaldeterioration
ACLSStudyGuide
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EffectiveTeamDynamics1. Clearrolesandresponsibilities:Teamleadershouldclearlydelegatetasks2. Knowingyourlimitation:Stayinscopeofpractice/askforanewroleifinappropriatelyassigned3. Constructiveinterventions:ifsomeoneisabouttomakeamistakeaddressthatteammemberimmediately4. Knowledgesharing5. SummarizingandRe-evaluation6. Closedloopcommunication:Repeatbacktheorder7. Mutualrespect
BradycardiaandTachycardia
BradycardiawithaPulse• Ifsymptomatic,giveAtropine,0.5mgevery3-5min,
maxtotaldoseof3mg(6doses)• Ifstable,12-leadandgetexpertconsultation
TachycardiawithaPulse
• Ifunstable,immediatesynchronizedcardioversion• Ifstable,12-leadandexpertconsultation• Ifstablew/narrowQRS:
• Adenosine1stdose6mg/2nddose12mg
CardiacArrest(NoPulse)
AssessmentFindings• Unresponsive• Nopulse&nobreathing• Mayhaveagonalgasps
pVT/VF
• CPRfirstandwhiledefibischarging• 1mgepinephrineq3-5min(alwaysfirst
medyougivewhenthepatientisdead)• Amiodarone1stdose300mg/2nd150mg• Only2shockablerhythmsincardiacarrest
ASYSTOLE/PEA
• CPRfirst• Notshockable• 1mgepinephrineq3-5min• IfnopulseandnotpVT,VF,or
asystole,thenyouhavePEA
ManualDefibrillation• Immediatelyafteryoushockàcompressions• Immediatelyifnoshockindicatedàcompressions• Whilesettingupdefibrillationtoshockà
compressions• ContinueCPRwhilethedefibischarging
PostResuscitation/AfterROSC1. Optimizeventilationandoxygenation2. TreatHypotension,SBP<90mmHg3. IfSTEMIàCathLab4. Ifunabletofollowcommand:targetedtemperature
management• 32-36Catleast24hours
TachycardiaRhythmswithaPulse
Stable=goodBPandgoodmentation/Unstable=lowBPandpoormentation
SinusTachycardia
AtrialFibrillation
SupraventricularTachycardia
MonomorphicVentricularTachycardia
AtrialFlutter
PolymorphicVentricularTachycardia
ACLSStudyGuide
ExpressTrainingSolutions|www.ExpressTraining.com|888.815.0313
BradycardiaRhythmswithaPulse
Non-symptomatic=goodBPandgoodmentation/Symptomatic=lowBPandpoormentation
SinusBradycardia
2ndDegreeHeartBlock,Type2
1stDegreeHeartBlock
3rdDegreeHeartBlock
2ndDegreeHeartBlock,Type1
PulselessRhythms(CardiacArrest)
1stStartCPR|2ndShockpVT/VFImmediately|3rdEstablishIVAccess&giveEpi|4thTreatReversibleCauses(H/T)
PulselessVentricularTachycardia(Monomorphic) Asystole
PulselessVentricularTachycardia(Polymorphic)
PEA(PulselessElectricalActivity)
VentricularFibrillation
PEAisanyorganizedrhythmwithoutapulsethatisnotVForpVT
